1. Technical Field
The technical field relates generally to surgical instrumentation and, more particularly, to a suturing apparatus suitable for use in endoscopic or laparoscopic surgical procedures.
2. Description of Related Art
During many surgical procedures in order to join tissue sections it is generally considered desirable to place two or three lines of stitching in the tissue sections, such as, for example, when performing an anastomosis to provide reinforcement. This is generally accomplished by providing a suturing device capable of passing a needle, having a length of suture material attached thereto, back and forth between jaws located on opposite sides of the tissues. One such device is disclosed in U.S. Pat. No. 4,236,470 to Stenson. The device of Stenson includes a pair of arms configured to alternately receive opposed ends of a needle-shuttle member. The shuttle member with an attached length of filament is passed alternately back and forth between the arms to stitch skin together.
Numerous surgical procedures are now being carried out endoscopically or laparoscopically. Endoscopic or laparoscopic procedures are characterized by the use of an elongated cannula having a relatively small diameter. The distal end of the cannula is passed through the surrounding tissue into the body cavity wherein the surgical procedure or examination is to be effected, thus providing a conduit for the insertion of surgical instrumentation. A plurality of cannulas may be used to allow insertion and operation of a variety of instruments simultaneously during a given procedure. For example, one cannula may provide a conduit for an endoscope for vision and illumination within the operative cavity while the other cannulas may provide conduits for control of specialized surgical instruments such as graspers, dissectors and staplers, designed for performing specific procedural functions.
During many endoscopic and laparoscopic procedures, it is necessary to rapidly and accurately place successive needle-suture combinations within the jaws of a surgical suturing apparatus for immediate and repeated use during the surgical procedure. Further, it is often necessary to hold the needles at specific locations along the needle body to facilitate suturing such as, for example, at one end or the other. Laparoscopic suturing presents a particularly challenging task, because it must be accomplished through a port that typically averages between five and ten millimeters. One instrument for facilitating laparoscopic suturing is discussed in British Patent Application No. 2260704, published Apr. 28, 1993.
Although the suturing device described in application Ser. No. 2260704 can be used to place laparoscopic sutures, once the suture is used up, or if a new needle is required, the suturing device must be re-loaded by inserting the suture within the device by hand, which can be very time-consuming. As it is generally considered desirable to place two or three lines of stitching when performing an anastomosis to provide reinforcement, the laparoscopic suturing device as described in the British application mentioned above may require manual reloading one or more times.
Another instrument for facilitating laparoscopic suturing is disclosed in German Patent Specification No. DE 41 24 383 C1. The device disclosed in DE 41 24 383 C1 includes a stationary jaw having a spring biased needle clamping device and a movable jaw having a movable two part clamping device. A needle can be moved back and forth between the jaws by pushing or pulling the needle into or out of the rigid jaw with the movable jaw by way of pneumatic actuation. When the needle is retained within the movable jaw it is releasable at any time and when the needle is retained within the stationary jaw it cannot be released without being pulled free.
In the devices listed above the shuttle member or needle may be released from the jaws when the jaws are at least partially opened. Thus, the shuttle or needle may be lost resulting in inconvenience or, if released during surgery, potential injury to a patient. Additionally, as in the case of U.S. Pat. No. 4,236,470 and German Patent Specification No. DE 41 24 383 C1, the jaws of the device may be opened before the shuttle or needle has been fully secured therein resulting in the aforementioned dangers.
Thus, it would be advantageous to provide a laparoscopic suturing instrument to permit quick, efficient and safe reloading of a new needle and suture. A laparoscopic suturing device would also provide an advantage if the surgical needle could not be released by the operator during a surgical operation while the jaws are in the open condition. It would be a further advantage if the jaws could be prevented from moving when the needle is not secured in either jaw, so as to prevent the needle from accidentally dislodging in the body cavity. It would be a still further advantage if the suturing device could be rapidly and precisely reloaded without touching the needle by hand.